Abstract 883: Association Between Cardiovascular Events and Comprehensive Management for Lifestyle-related Disease by General Practitioners: A Report From the “Heart Care Network” Groups
Background: It is believed that comprehensive management of lifestyle-related diseases (hypertension [HTN], hypercholesterolemia [HC] and diabetes mellitus [DM]) should be performed to prevent cardiovascular (CV) events. However, there are few reports on the efficacy of such comprehensive management in preventing CV events. Therefore, we investigated the association between CV event and comprehensive management using the observational data from the Heart Care Network (HCN) groups which were organized mainly by general practitioners treating lifestyle diseases in 62 areas of Japan.
Methods: The HCN has collected data on lifestyle diseases in high-risk patients (patients has ≥2 condition in lifestyle disease or those with a history of myocardial infarction [MI]), and investigated management conditions and medication during 3-year follow-up period. Additionally, incidence of fatal/non-fatal CV events was also assessed. We compare the event-free survival between comprehensive management achieved group, which means LDL cholesterol <130 or 100 (in cases with DM or MI) mg/dl and blood pressure <140/90 or 130/80 (in cases with DM) mmHg and hemoglobinA1c <6.5 or 7.0 (in cases with DM) %, and not achieved group.
Results: We analyzed 10,291 cases. The incidence of CV events in the achieved group (N=1064, 10.3%) was significantly lower than not achieved group (2.4% vs 4.3%, figure⇓) even after adjustment of age, gender and body mass index (HR 0.61, P=0.018).
Conclusion: The comprehensive management for lifestyle diseases in high-risk patients by general practitioner might be able to reduce cardiovascular morbidity and mortality sufficiently.